treatment primary infection
Jun 20, 2004
what is the thinking now about treating primary infection - does it depend on cd4/ vl? how long after exposure/primary infection is it still considered worth while to treat for the 6-12 month arbitrary period?
thanks for your help
Response from Dr. Pierone
The current thinking about treating primary HIV infection is that, although unproven, it may be desirable. There are data that patients treated early may experience better immunologic control of virus and a more benign clinical course after treatment is withdrawn. The CD4 and viral load are probably not the deciding factor in this scenario.
The studies of early treatment that have been suggestive of benefit have largely confined themselves to those patients within 3 months of acquisition of seroconversion. Some of the studies only looked at people before seroconversion when HIV was diagnosed on the basis of positive HIV RNA levels (viral load). Yes, the arbitrary 6-12 month period of treatment is still the ballpark number. It would not be wrong to treat shorter or longer or use an STI approach (similar to the Walker/Rosenberg cohort) or not treat at all since we honestly don't have definitive data.
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